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NOTE: PULL AL,ERMITS (Septic, Well, etc.) MAKtpPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005732 <br /> DATE RECEIVED by EHD: October 26,2005 APPL#: PA-0500714 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2626 <br /> USE PERMIT-GENERAL(UP) <br /> COMPLETE&SUBMIT BY: Wed, November 9, 2005 <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 23073 S FREDERICK RD,RIPON APN : 22813021 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit(i.e., sewage disposal, water <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of house,wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 42 <br /> 07 )&VISEd <br /> I recommend: Approval yf o Denial Continuance Inspector: � , <br /> SSignature <br /> Supervisor/Lead Senior COMMENTS: <br /> B _ ' <br /> M <br /> d d <br /> (l <br /> Y/ 1 <br /> _ V <br /> SUP[>IiVISOR / LEAD SENIOR Approval: Date: <br /> OA d Check Off List: Proofread Report? Correc <br /> Correct CONDITION(S)? I ol"gcd w I;� <br /> EH 06 06 Report#7201 October 27,2005 <br />